I welcome this opportunity to share the progress we have made in the first quarter of the 2010/11 financial year to achieve the outcome of a long and healthy life for all South Africans.
To achieve this outcome we have decided to focus on four broad areas which are:
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reducing mortality rates
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addressing HIV and AIDS
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reducing the burden of tuberculosis (TB) and
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improving the effectiveness of the health system.
Reducing mortality rates
In Gauteng many mothers die during child birth; last year a total of 311 mothers died during child birth, representing a rate of 154 deaths per 100 000 live births.
The reasons for this include non-pregnancy related infections due to HIV and AIDS. This accounted for nearly half of all the deaths. Other causes are bleeding before and after birth (obstetric haemorrhage), hypertension, pregnancy related sepsis (illegal abortions) and pre-existing medical conditions such as heart disease.
In the last quarter we undertook a number of interventions to reduce number of mothers dying during child birth.
From April we started providing antiretroviral (ARV) therapy to all women with a CD4 count of 350 or less or with AIDS defining symptoms regardless of the CD4 count. All deaths of pregnant mothers are monitored from central office and every incident is fully investigated to identify avoidable factors and address identified deficiencies.
We also encourage pregnant women to attend antenatal care early in their pregnancy to enable early identification of conditions in pregnancy that can be managed medically and thus improve survival. Early booking also benefits HIV positive mothers by granting them access to antiretroviral therapy and Prevention of Mother to Child Transmission (PMTCT) programme.
The interventions we made last year have given us a reason to be hopeful that with focused attention and training we can reduce the number of mothers dying during child birth.
Last year we witnessed a significant decrease in deaths due to pregnancy related hypertension from 21.1 percent to 13.9 percent as a result of training of staff on the correct management of pregnancy related hypertension.
Furthermore, we have strengthened the prevention of Prevention of Mother to Child Transmission programme. From April this year, HIV positive pregnant mothers qualify to be on the programme at 14 weeks of pregnancy instead of 28 weeks previously.
The PMTCT programme has achieved a reduction in the percentage of children who are HIV infected. In 2008 the rate ranged from eight percent to 10.6 percent and this was reduced to a range of 5.1 percent to 7.2 percent in 2009. This means nine out 10 children born to HIV positive mother do not have HIV. We hope that by introducing preventive medication at early stage in pregnancy of HIV-positive women, we may be able to completely prevent the transmission of HIV to new born babies.
In addition we have established two committees comprising of experts in their fields. One committee is the maternal mortality committee which will review causes of deaths among pregnant mothers and make recommendations.
The other is the perinatal and child mortality committee which will review causes of deaths among babies and make recommendations. Furthermore we are planning a summit in September to devise strategies to deal with deaths and injuries among babies and mothers in the province.
To improve the survival rate among children, we undertook polio and measles immunisation campaigns in April and May this year. Statistics suggest that Gauteng is immunising a lot more babies than expected as the measles coverage rate has been measured at 146 percent for children aged six to 59 months and 118 percent for children aged five to 15 years.
This suggests that babies born in other provinces and countries plus some whose births were not registered have been reached by the campaigns. However the measles outbreak that occurred last year points out that we have to be vigilant at all times. We therefore ask mothers and caregivers not to wait for campaigns but to take children to clinics for regular immunisation because "every day is immunisation day" in Gauteng.
Substance abuse is one of the main challenges which undermine life expectancy of young people in the province. This results in a myriad of social problems including crime, poverty, reduced productivity, unemployment, dysfunctional family life and the escalation of diseases such as HIV and AIDS.
In the last quarter the department and non-profit organisations (NPOs) undertook awareness and prevention campaign in communities. Funding was provided to 14 NPOs for outpatient programmes for rehabilitation providing services to 1661 beneficiaries.
Addressing HIV and AIDS
Gauteng prides itself on a strong multisectoral approach to HIV prevention and care. The department's goal is to reduce new HIV infections by 50 percent by 2011. In April we launched a massive HIV counseling and testing campaign (HCT) including health screening with the aim of reaching 3.3 million people by June 2011.
The campaign is conducted in all clinics and hospitals. We targeted big events such as Worker's Day, 2010 FIFA World Cup fan parks and Women's Day in the previous months to encouraging testing. Through this campaign we have managed to test 502 882 people since April.
Together with the private sector in particular Netcare through its network of primary healthcare facilities and independent practitioners have agreed to join hands in the campaign we aim to reach 1.5 million people.
In the coming months the department will be taking the campaign to hostels and public transport hubs. Malls will also be targeted at the end of every month to reach more people.
An additional 17 508 people were enrolled in the antiretroviral component of our comprehensive HIV and AIDS treatment and care programme in the first quarter of this financial year, bringing to 304 189 the total number of people who have received antiretroviral therapy (ART) since 2004.
Reducing the burden of TB
The prevalence of TB in Gauteng continues to be a challenge cases have increased from 441 per 100 000 people in 2008 to 502 per 100 000 in 2009. The department's intensified TB case finding resulted in an increase in the number of patients treated from 45 937 in 2008/09 to 49 535 in 2009/10. This represented a 7.8 percent increase in the number of patients treated.
The number of patients who defaulted on treatment decreased slightly from six percent in 2009 to 5.9 percent in the first quarter of this year. The cure rate has reached 80 percent in this quarter.
The reduction in the number of defaulter has been achieved through the institution of defaulter tracer teams in all districts. These teams are constituted by retired professional nurses and data capturers and the department plans to increase them to assist in reducing the treatment interruption rates and sustain the improvement in TB cure rates.
Improving the effectiveness of the health system
The department is a very large and complex operation. In 2009/10 it recorded 24.5 million visits to clinics, community health centers and hospital out-patient departments. A total of 181 000 babies were delivered at hospitals and clinic obstetric units.
To respond to the demand for better quality of health services the department employed an additional 19 medical doctors; 28 medical specialists; 270 professional nurses; 58 staff nurses; and 34 pharmacists in the last quarter.
In addition a total of 1 908 interns and community service profession were placed in different hospitals throughout the province.
Thirty four out of 35 community health centres (i.e. Khutsong CHC) have resident doctors and 248 out of 318 fixed clinics are supported by a doctor at least once a week. Family physicians have been devolved from tertiary hospitals to strengthen district hospitals and Primary healthcare facilities (PHC).
In preparation for the establishment of health post, 500 community health workers have been trained and allocated to Kliptown area. A further 1 000 will be trained in the next quarter.
A total of 60 ambulances were delivered in the previous quarter. This ensured that services to communities were not interrupted during the 2010 FIFA World Cup. The availability of ambulances has also assisted in achieving a response of less than 40 minutes in rural areas of Metsweding.
However the retention of health professionals, waiting times, regular supply of medicines and monitoring of non-profit organisations are issues requiring ongoing attention if we are to truly improve the performance of the system.
Social development
The mandate of the department includes the provision of social development services and programmes that promote sustainable living of poor and vulnerable families and communities.
The department has invested in capital infrastructure to provide social welfare facilities in communities that previously did not have community-based welfare services.
In the last quarter the department commenced construction of early childhood development centres in Sedibeng and three care facilities for older persons in Kagiso, Sharpville and Munsieville.
In line with the new Older Person's Act of 2006 and to ensure equitable distribution of resources, the department reviewed its funding criteria for the 2010/11 financial year to all funded residential facilities for the aged. Sixteen homes were identified to be having unit costs above R5 000 per month and had a low number of subsidised residents compared to the total number of all accommodated residents.
After careful consideration of all facts and deliberation with the homes, funding for 12 homes was terminated from July 1 2010 because they were not accessible, affordable, appropriate, cost-effective and efficient.
Affected homes were: Sandringham Gardens, Our Parents Home, Deansgate Old Age Home, St Christopher Association: Summerfield Old Age Home, Cosmos House Old Age Home, JAFTA, Rynpark Field, Protea Home, Fairleads Old Age Home, Ron Smith Care Centre, Deutches Altersheim Old Age Home, and Roodepoort Centrum.
Funding for the following four homes: Queenshaven, Queen Alexandra, Ekklesia Park and Rusoord Centurion, was reduced to only cover poor residents.
The War on Poverty continues to be an area of focus and the programme is implemented in partnership with the Department of Local government as well as youth volunteers (known as MaSupatsela) recruited and trained by the Department of Health and Social Development. The programme has brought about tangible benefits to the people in household profiled.
These benefits range from employment opportunities, social relief of distress, and access to a variety of government services including grants and identity document applications, school enrolments, participation in learnership programmes and accessing health services.
In the quarter under review, a total of 4647 households have been profiled. In addition four food banks were established in the quarter under review. A total of 815 beneficiaries have benefitted from food relief provided by these food banks.
Our luncheon clubs and drop-in centers where the elderly are taken care of during the day through the provision of meals, health and exercises play a vital role in ensuring our senior citizens are cared for with the dignity and respect accorded to them.
Conclusion
In conclusion I would like to thank all the people who are volunteering in hospitals during the current public sector strike. Through the selfless actions, these people are demonstrating the true spirit of ubuntu and their effort are very much appreciated.
I also want to thank all the people who offered support and donations when the Peter Wessels old age home was burnt down and more than 20 elder people died. Alternative accommodation for all the people who were displaced after that tragic incident has been found and the people have been appropriately housed.
Thank you.
Enquiries:
Mandla Sidu
Cell: 082 773 9013
Simon Zwane
Cell: 082 551 9892
